Weisman de Mamani Amy, Weintraub Marc J, Gurak Kayla, Maura Jessica
Department of Psychology.
J Fam Psychol. 2014 Dec;28(6):800-10. doi: 10.1037/fam0000021. Epub 2014 Oct 6.
Research strongly suggests that family interventions can benefit patients with schizophrenia, yet current interventions often fail to consider the cultural context and spiritual practices that may make them more effective and relevant to ethnic minority populations. We have developed a family focused, culturally informed treatment for schizophrenia (CIT-S) patients and their caregivers to address this gap. Sixty-nine families were randomized to either 15 sessions of CIT-S or to a 3-session psychoeducation (PSY-ED) control condition. Forty-six families (66.7%) completed the study. The primary aim was to test whether CIT-S would outperform PSY-ED in reducing posttreatment symptom severity (controlling for baseline symptoms) on the Brief Psychiatric Rating Scale. Secondary analyses were conducted to test whether treatment efficacy would be moderated by ethnicity and whether patient-therapist ethnic match would relate to efficacy and patient satisfaction with treatment. Patients included 40 Hispanic/Latinos, 14 Whites, 11 Blacks, and 4 patients who identified as "other." In line with expectations, results from an ANCOVA indicated that patients assigned to the CIT-S condition had significantly less severe psychiatric symptoms at treatment termination than did patients assigned to the PSY-ED condition. Patient ethnicity and patient-therapist ethnic match (vs. mismatch) did not relate to treatment efficacy or satisfaction with the intervention. Results suggest that schizophrenia may respond to culturally informed psychosocial interventions. The treatment appears to work equally well for Whites and minorities alike. Follow-up research with a matched length control condition is needed. Further investigation is also needed to pinpoint specific mechanisms of change.
研究有力地表明，家庭干预对精神分裂症患者有益，但目前的干预措施往往未能考虑到文化背景和精神实践，而这些因素可能会使干预措施对少数族裔人群更有效且更具针对性。我们针对精神分裂症（CIT-S）患者及其护理人员开发了一种以家庭为重点、具有文化针对性的治疗方法，以填补这一空白。69个家庭被随机分为接受15次CIT-S治疗或3次心理教育（PSY-ED）对照治疗。46个家庭（66.7%）完成了研究。主要目的是测试CIT-S在降低简明精神病评定量表上的治疗后症状严重程度（控制基线症状）方面是否优于PSY-ED。进行了二次分析，以测试治疗效果是否会因种族而有所不同，以及患者与治疗师的种族匹配是否与疗效和患者对治疗的满意度相关。患者包括40名西班牙裔/拉丁裔、14名白人、11名黑人以及4名自称“其他”的患者。与预期一致，协方差分析的结果表明，接受CIT-S治疗的患者在治疗结束时的精神症状明显比接受PSY-ED治疗的患者轻。患者种族以及患者与治疗师的种族匹配（与不匹配相比）与治疗效果或对干预的满意度无关。结果表明，精神分裂症可能对具有文化针对性的心理社会干预有反应。这种治疗方法对白人和少数族裔的效果似乎同样良好。需要进行有匹配长度对照条件的随访研究。还需要进一步调查以确定具体的改变机制。
